DR. KEITH B TOM (DO) – Family Medicine Physician, NPI 1609850130
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,418 FAMILY PRACTICE in MI
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Provider Addresses for DR. KEITH B TOM (DO)
49221, Van Dyke Avenue, Shelby Charter Township, Macomb County, Michigan, 48317, United States
SHELBY TWP, MI 483171336
Phone: (586) 254-4860
Fax: (586) 254-5844
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 23 Open Payments records for all available years, with a total value of $398.
Total Amount is formed as General ($398) + Research ($0) + Ownership ($0) = $398.
Last reported payment date: 2024-10-24 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($86).
Total Amount
$398
General + Research + Ownership
Payments
23
Total payment records
General Amount
$398
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-12-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20041215000775 | I | Family Practice | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 205 | 101 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 187 | 85 | $0 |
| 81000 | Manual urinalysis test with examination using microscope, non-automated | 101 | 87 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 89 | 89 | $0 |
| G0444 | Annual depression screening, 5 to 15 minutes | 85 | 85 | $0 |
Insurance plans in this area (ZIP 48317)
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